Ultrasonographic investigation of kidney size, and associated factors among diabetic outpatients at jimma university medical center, southwest Ethiopia

Abstract

BACKGROUND: Ultrasonographic assessments of the kidney size is useful in diagnosis of chronic renal pathologies among patients with non-communicable diseases including diabetes mellitus (DM), which is one of the major public health problems in Ethiopia. Renal Doppler ultrasound is standard imaging modality in the investigation of kidneys. OBJECTIVES: The study is aimed to investigate the effect of diabetes on the kidneys using ultrasonography, specifically on the anatomical size and vascularity of kidneys by Doppler ultrasound in diabetic patients. METHODS: Hospital based cross sectional study was conducted from June 26 to August 26, 2018 at Jimma University medical center, chronic follow up clinic Jimma Ethiopia. Renal size was assessed by ultrasound among diabetic adult patients who fulfill inclusion criteria. The data were collected by using structured questionnaires and entered to Epi-Data version 3.1 and were analyzed using SPSS version 20.0. Descriptive statistics and linear regression analysis were used for analysis and statistically significance was declared at p< 0.05. RESULTS: The mean lengths in all age groups of right and left kidney were 10.263±0.764cm and 10.421±0.714 respectively. The mean volume of right and left kidney in all age groups were 98.115±23.118 cm and 101.423±24.457 cm respectively. In bivariate analysis right kidney length has negative & positive correlation with Age (r=-0.163, p-value=0.031), body height(r=0.137,P-value=0.070), body weight (r=0.309, p-value=0.001), BMI(r=0.234 , pvalue=0.002), duration of diabetes (r=-0.111, p-value=0.142), Type of DM (r=-0.095, pvalue=0.211), DBP (r=0.115, p-value=0.128.In bivariate analysis of left kidney has negative & positive correlation between left kidney length, Age(r=-0.121,p-value=0.111) sex(r=-0.099, p - value=0.192), height(r= 0.198 ,p- value= 0.009), weight ( r= 0.271, p- value= 0.001), BMI( r= 0.156, p- value= 0.036), Duration of DM (r=-0.121, p- value= 0.112), Type of DM (r=-0.124, p- value= 0.103), DBP( r=0.147, p- value= 0.05). Multivariable linear regression analysis, Age (p-value=0.001, p-value=0.013), body height (p-value=0.001, p-value= 0.000), BMI (pvalue=0.000, p- value=0.001) showed significant correlations with right and left kidney length respectively. Regarding volume of the kidney only body height (p-value=0.003, p-value=0.017) and BMI (p-value=0.001, p-value=0.000) showed significant correlation with right and left kidney respectively. CONCLUSION AND RECOMMENDATION: This study has provided measurements of renal length, width, thickness & predictors of kidney size among diabetic patients at chronic follow up clinic in Jimma University medical center. Renal length has a direct relationship with Age, Body height and BMI. To researcher further study has to be conducted with larger sample size. For clinical practitioners they can use this data as an input for clinical decisions particularly during diabetic patient management & kidney related problems in general.